Comparison of the effects of acid-citrate-dextrose (ACD) and trisodium citrate (TCC) molecules used as anticoagulants during granulocyte apheresis on the number of granulocyte collected at the end of granulocyte apheresis

Infections are an important cause of morbidity and mortality in immunosuppressed patients due to neutropenia. In these patients apart from antibiotic therapy, granulocyte transfusion is used as a treatment option. It is essential to collect sufficient numbers of granulocyte for an effective transfusion. In our study, it was aimed to retrospectively analyze the effect of the different anticoagulants used during the procedure on the total granulocyte count of the granulocyte products of the donors. 295 donors who donated granulocytes between 2016-2020 were included in the study. Twenty-five (8.5%) of the granulocyte donors were female and 270 (91.5%) were male. The median age of the donors was 31 (24-39). During the apheresis procedure, acid-citrate-dextrose (ACD) was used in 229 (77.6%) donors, trisodium citrate (TCC)+hydroxyethylstarch (HES) in 52 (17.6%) donors and ACD+HES in 14 (4.7%) donors. The median granulocyte value of products in the donors using ACD during apheresis was 0.96 x1010/ml, the median granulocyte value of the products in the donors using TCC+HES was 2.46 x1010/ml and the median granulocyte value of products in the donors using ACD+HES was 0.62 x1010/ml. The total granulocyte count was found to be statistically significantly higher in the group with TCC+HES collecting granulocytes compared to the groups with ACD+HES and ACD collecting granulocytes (p<0.05). The granulocyte count was found to be statistically significantly higher in the group in which granulocytes were collected with ACD than in the group collected with granulocytes with ACD+HES (p<0.05). The median hemoglobin value in the product of donors who used ACD during apheresis was 6.3 (5.1-7.8) g/dl, the median hemoglobin value in the product of donors who used TCC+HES was 5.1 (4.5-6.6) g/dl and the median hemoglobin value in the product of donors who used ACD+HES was 6.9 (6.7-8.7) g/dl. The hemoglobin level of the product collected by TCC+HES was found to be significantly lower than the hemoglobin levels of the products collected by ACD and ACD+HES (p<0.05). The hemoglobin level of the product collected by ACD was found to be significantly lower than the hemoglobin level of the products collected by ACD+HES (p<0.05). Keywords: Granulocyte, apheresis, acid-citrate-dextrose, trisodium citrate